Taking the Initiative

The AIDS plan that came out of the G8 meeting is a step in the right direction. But it's not enough.

| Tue Jun. 15, 2004 2:00 AM EDT

The AIDS epidemic garnered new attention this week as G-8 leaders agreed upon a plan to accelerate worldwide HIV vaccine research. President Bush led the way, pledging $15 million towards launching an international "Global HIV Vaccine Enterprise," which would spur closer collaboration between research laboratories around the globe. Vaccine work has proceeded rather ploddingly of late, as researchers have encountered financial and logistical difficulties in sharing information with colleagues and coordinating efforts. Dr. Anthony Fauci of the National Institutes of Health noted the bright prospects for this new project:

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'When other nations … decide they want to align their own resources or put new resources into vaccine development, there will be a strategic plan framework with which they can synergize.'

The need for this kind of synergy has existed for some time now. In a Science article written in 2003, Dr. Fauci and Dr. Richard Klausner explained how HIV research had reached a semi-stalemate, owing to an incomplete understanding about how the virus actually works. They wrote:

The best engine for solving these major scientific challenges is the creativity of individual scientists working together in multidisciplinary problem-solving consortia, adequately resourced and linked to vaccine development capabilities.

Not everyone shares Fauci's enthusiasm for the new project. A few critics called the funding inadequate, and argued that the initiative does little to address pressing needs. As Salih Booker, an executive at the AIDS activist group Africa Action, said:

'Africa's AIDS crisis and the continent's debt burden are two urgent life-and-death priorities for the continent, yet the G-8 today has offered nothing new or concrete on either one.'

The critics may be overzealous--the new initiative does look promising, and it has the backing of the World Health Organization--but they certainly have ample reason to be skeptical. To date, President Bush's pledges to fight AIDS have fallen woefully short of their intended mark. In his 2003 State of the Union speech, he drew stunned applause for promising $15 billion in AIDS relief to Africa and the Caribbean over five years--a surprising sum that dwarfed the $2 billion that Bill Clinton had pledged as president. A year later, most of the once-charmed are left asking, "What happened?" The earmarked money has yet to be released from the U.S. Treasury, and as of January 2004, Newsweek reported that "the administration’s office of the Global AIDS Coordinator still operates with a skeleton staff borrowed from other departments while dozens of its positions remain unfilled." Newsweek does the relevant finger-pointing:

Part of the blame for the hold-up falls on Congress, where an omnibus spending bill that would deliver the first installment of $2.4 billion remained stalled until late last week. But while Bush—to much fanfare—authorized Congress to spend up to $3 billion on AIDS this year, the administration lobbied lawmakers privately to hold that appropriation to $2 billion. They eventually compromised on $2.4 billion.

The delay also stems in part from the administration's refusal to work with the U.N.-backed Global Fund. Bush claims that new health infrastructure needs to be created in order to deliver the money properly, although most observers agree that the Global Fund could make good use of the money right now. According to Newsweek, critics charge that "the administration is hesitant to direct much of the money to the Fund because it would then have to share credit for saving lives with other countries." Even House Republicans have found Bush's unilateralism tiresome, and recently voted to triple Bush's request for money to the Global Fund.

There is also some indication that Bush simply prefers to work with religious groups outside of the U.N., even if those groups have little experience with AIDS work. The New York Times editorial board pointed out that the administration wants to break with UN practice by promoting abstinence-only education for youth, the ineffectiveness of which can prove "deadly" in Africa.

Letting ideology hamper AIDS prevention is bad enough, but two weeks ago the Washington Post reported that funding allocations have been heavily influenced by pharmaceutical interests as well. The administration refuses to spend any of the $15 billion on generic AIDS drugs, proposing instead to lavish the money on American drug companies, which often charge 4 or 5 times the cheaper generic rate.

Earlier this year, The Nation's Naomi Klein pointed out another instance of pharmaceutical pandering. In August of 2003, the U.S., at the behest of drug lobbyists, successfully held up a WTO agreement to allow poor countries with health problems the right to import generic drugs. Klein called it cronyism, plain and simple, and swatted down all the usual excuses for such a move:

Bale has pulled out all of Big Pharma's favorite myths: Africa doesn't need cheap drugs, it needs infrastructure (it needs both); brand name companies have already slashed their prices to compete with generics (discounted brand versions are still at least twice as expensive); weakening patents will hurt corporate profits and destroy the incentive for new research (Africa accounts for roughly 1 percent of the $400 billion pharmaceutical industry's total sales).

Indeed, there are no excuses. In regions such as sub-Saharan Africa--home to a quarter of the world's HIV victims--most governments have done little to curtail the spread of AIDS. The burden now falls squarely on the UN and the U.S. In the time since Bush's State of the Union speech, 3 million people have died of AIDS. Until the administration stops slavering to drug lobbyists and starts getting serious about AIDS relief, that number will continue to rise without end.